Form: 8.99

_____________________________________________________(name
and address) referred to as Husband and
_____________________________________________________(name and
address) referred to as Wife, agree:

The parties were
lawfully married on ___________________, _______, at
_________________________________________________ (name and
location). Troubles have occurred between the parties, and they
have agreed to live separate and apart.

The parties
nevertheless desire to resolve certain issues and consequently,
have entered into this agreement.

The parties have
children born of this marriage who are as follows:

Name Age Date of
Birth

1).
__________________________ ________ _________________

2).
_________________________ _________ _________________

3).
_________________________ _________ _________________

The parties have made
a complete disclosure to one another of financial matters and
each is satisfied that they have had sufficient disclosure of
the parties individual and joint finances.

The parties have each
been advised by counselors of their own choice regarding their
legal rights and any disclosures made herein.

The husband shall
assume the following debts and shall not hold the wife
responsible for the same:

_____________________________________________________

_____________________________________________________

_____________________________________________________

The wife shall assume
the following debts and shall not hold the husband responsible
for the same:

_____________________________________________________

_____________________________________________________

_____________________________________________________

Neither party shall
incur any further debts which may result in joint liability. In
the event that either party incurs a debt on joint credit of the
parties, that party shall be responsible for the total amount of
that debt.

The (husband/wife)
shall maintain health insurance for the benefit of
__________________________________________________ .

Personal property of
the parties shall be divided as follows:

The Husband shall
have the following property:
_____________________________________________________

_____________________________________________________

_____________________________________________________.

The Wife shall have
the following property:
_____________________________________________________

_____________________________________________________

_____________________________________________________.

If any debts are
associated with the items of property divided herein, the party
receiving the same shall assume the debt and hold the other
party harmless from such debts.

Any property not
specifically divided herein shall be subject to distribution at
a later time.

The
____________________ (husband/wife) shall have temporary
possession of the residence owned by the parties located at
____________________________________.

Expenses related to
the residence shall be borne by the parties as follows:

Husband:
_____________________________________________________

_____________________________________________________

Wife:
_____________________________________________________

_____________________________________________________

The parties agree
that this agreement is intended to be a final disposition of the
matters agreed upon herein. This agreement may be introduced
into evidence and incorporated in a final decree of dissolution
of marriage. In the event that any disputes occur regarding this
agreement, the prevailing party shall be entitled to reasonable
attorneyï¿½s fees regarding such
enforcement._________________________ __________________

Signature of Husband
Date

_________________________
__________________

Signature of Wife
Date

_________________________
__________________

Witness for Husband
Date

_________________________
__________________

Witness for Wife Date

________________________
My commission expires on:

Notary Public

Warning:

These forms are
provided AS IS. They may not be any good. Even if they are good
in one jurisdiction, they may not work in another. And the facts
of your situation may make these forms inappropriate for you.
They are for informational purposes only, and you should consult
an attorney before using them.